
<%@ include file="/view/template/header.jsp"%>	
	<div id="content">
    	<%@ include file="/view/ehr/ehr_common.jsp"%>
		<script>
			$(function() {
				$("#tabs").tabs();
			});

		</script>
		<h1><s:label key="label.patient.patient_details" cssClass="label_text"></s:label></h1>
		<div class="right-content">
		<h3><s:if test='replyMessage.message!="empty"'>
					<s:property value="replyMessage.message"/>
			</s:if></h3>
			
			<s:form method="post">
			 <div class="box">
			 

				<div id="tabs">
					<ul>
						<li><a href="#tabs-1"><s:label key="label.personal_details" cssClass="label_text"> </s:label></a></li>
						<li><a href="#tabs-2"><s:label key="label.contact_details" cssClass="label_text"> </s:label></a></li>
					</ul>
					<div id="tabs-1">
					  <div class="sub_box">
					  
					  <div class="con-part">
							<span>
								<s:label key="label.patient.patientId" cssClass="label_text"></s:label>
							</span> 
							<s:textfield name="patientDetails.patient.patientId" readonly="true" class="input-text"></s:textfield> 
						</div>
					  <div class="con-part">
							<span>
								<s:label key="label.patient.prefix" cssClass="label_text"></s:label>
							</span>
							
							<s:select name="patientDetails.patient.prefix"
								list="#{'Rev.': 'Rev.', 'Dr.': 'Dr.', 'Mr.': 'Mr.', 'Mrs.': 'Mrs.', 'Miss.': 'Miss.'}"
								headerKey="0" headerValue="---Select Prefix---"
								
								class="select_box" disabled="true"
								>
								</s:select>
							
							</div>
							
						<div class="con-part">
							<span>
								<s:label key="label.patient.givenName" cssClass="label_text"></s:label>
							</span> 
							<s:textfield name="patientDetails.patient.givenName" class="input-text" readonly="true"></s:textfield> 
						</div>
						<div class="con-part">
							<span>
								<s:label key="label.patient.familyName" cssClass="label_text"></s:label> 
							</span>
							<s:textfield name="patientDetails.patient.familyName" class="input-text" readonly="true"></s:textfield>
						</div>
						 
						<div class="con-part">
							<span>
								<s:label key="label.patient.gender" cssClass="label_text"></s:label>
							</span> 
							<s:radio name="patientDetails.patient.gender"  list="#{'1': 'Male', '2': 'Female'}" cssClass="input-radio" disabled="true"/>
						</div>
						
 						 <div class="con-part">
 						 	<span>
 						 		<s:label key="label.patient.dob" cssClass="label_text"></s:label>
 						 	</span>
							<s:textfield name="patientDetails.patient.birthTime" id="datetimepicker" class="input-text" cssErrorClass="error"></s:textfield>
						</div> 
						
						<div class="con-part">
							<span>
								<s:label key="label.patient.nic" cssClass="label_text"></s:label>
							</span>
							<s:textfield name="patientDetails.patient.nicNo" class="input-text" readonly="true"></s:textfield>
						</div> 
						
						<div class="con-part">
							<span>
								<s:label key="label.patient.birthPlace" cssClass="label_text"></s:label>
							</span> 
							<s:textfield name="patientDetails.patient.birthPlaceAddress" class="input-text" readonly="true"></s:textfield> 
						</div> 
						
						<div class="con-part">
							<span>
								<s:label key="label.patient.maritialStatus" cssClass="label_text"></s:label>
							</span> 
							<s:radio name="patientDetails.patient.maritialStatus" list="#{'1': 'Single', '2': 'Married'}" cssClass="input-radio" disabled="true"/> 
						</div> 
						
						<div class="con-part">
							<span>
								<s:label key="label.patient.religion" cssClass="label_text"></s:label>
							</span>
							
							 <s:select name="patientDetails.patient.religiousAffliationId"
								list="#{'1': 'Buddhism', '2': 'Muslim', '3': 'Hindu', '4': 'Other'}"	
								headerKey="0"				
								headerValue="--Select relogion--"
								class="select_box" disabled="true">
							</s:select> 
							
						</div> 
						
						<div class="con-part">
							<span>
								<s:label key="label.patient.ethnicGroup" cssClass="label_text"></s:label>
							</span>
							<s:select name="patientDetails.patient.ethnicGroupId"
								list="#{'1': 'Sinhalese', '2': 'Muslim', '3': 'Tamil', '4': 'Other'}"
								headerKey="0"
								headerValue="--Select Ethnic Group--" 
								class="select_box" disabled="true">
							</s:select> 
						</div>
					</div>
					</div>
					<div id="tabs-2">
					<div class="sub_box">
						<h2>Address</h2>
						<div class="con-part">
							<span>
								<s:label key="label.address.houseNo" cssClass="label_text"></s:label>
							</span> 
							<s:textfield name="patientDetails.patientAddressList.houseNumber" class="input-text" readonly="true"></s:textfield> 
						</div> 
						
						<div class="con-part">
							<span>
								<s:label key="label.address.streetName" cssClass="label_text"></s:label>
							</span> 
							<s:textfield name="patientDetails.patientAddressList.street" class="input-text" readonly="true"></s:textfield> 
						</div> 
						
						<div class="con-part">
							<span>
								<s:label key="label.address.city1" cssClass="label_text" ></s:label>
							</span>
							<s:textfield name="patientDetails.patientAddressList.city1" class="input-text"></s:textfield> 
						</div> 
						
						<div class="con-part">
							<span>
								<s:label key="label.address.city2" cssClass="label_text"></s:label>
							</span>
							<s:textfield name="patientDetails.patientAddressList.city2" class="input-text" readonly="true"></s:textfield> 
						</div> 
						
						<div class="con-part">
							<span>
								<s:label key="label.address.country" cssClass="label_text"></s:label>
							</span>
							<s:select name="patientDetails.patientAddressList.country"
								list="#{'1': 'Sri Lanka', '2': 'USA.', '3': 'India', '4': 'Australia', '5': 'Other'}"
								headerKey="0" headerValue="---Select Country---"
								
								class="select_box" disabled="true">
							</s:select>
							
						</div>
						
						
						<div class="con-part"></div>
						<s:if test="patientDetails.patientEmailList.size > 0">

<s:iterator value="patientDetails.patientEmailList">
						<div class="con-part">
							<span>
								<s:label key="label.patient.email" cssClass="title_label_text"></s:label>
							</span> 
							<s:textfield name="email" class="input-text" readonly="true"></s:textfield> 
							<!-- <a href="javascript:void(0);"> <span class="remove_email">Remove</span></a> -->
						</div>
						</s:iterator>
						</s:if>
						</div>
						
						
						<!-- <div class="con-part"><span>&nbsp;</span> <a href="javascript:void(0);"
							 id="addemail" class="green">Add more</a> </div> -->
							
						<div class="con-part"></div>
						<s:if test="patientDetails.patientTelephoneList.size > 0">

<s:iterator value="patientDetails.patientTelephoneList">
						<div class="con-part">
							<span>
								<s:label key="label.patient.telephone" cssClass="title_label_text"></s:label>
							</span> 
							<s:textfield name="telephoneNo" class="input-text" readonly="true"></s:textfield> 
						</div>
						 </s:iterator>
						 </s:if>
				
					</div>	
				</div>

				<div class="button_bar4">
				<s:url action="view_ward" var="view_ward_action">
						<s:param name="patient_id" value="%{patientDetails.patient.patientId}"/>
					</s:url>
					<a href="${view_ward_action}" class="green"><s:text name="label.admitPatient"/></a>
				<s:url action="update_patient" var="update_patient_action">
					<s:param name="patient_id" value="%{patientDetails.patient.patientId}"/>
				</s:url>
				<a href="${update_patient_action}" class="green"><s:text name="label.updatePatient"/></a>
		
				</div>
</div>
			</s:form>
			
		</div>
	</div>

	<%@ include file="/view/template/footer.jsp"%>